Nearly 9 in 10 patients have symptoms even two months after recovering from coronavirus, finds study

Nearly 9 in 10 patients have symptoms even two months after recovering from coronavirus, finds study
(Getty Images)

While much remains unknown about the new coronavirus, some people are now reporting lingering symptoms of the illness for weeks and months after recovery, and a new study provides further evidence of the persistent and long-lasting health effects after a coronavirus infection. A vast majority of patients, who were monitored after recovering from Covid-19, were still experiencing at least one symptom two months later, according to researchers of a new study.

Overall, the research team found that about nine in 10 people have persistent symptoms months after recovering from severe Covid-19. Fatigue and shortness of breath were the most common symptoms reported in the study of 143 patients. More than half of the patients were still experiencing three or more symptoms. The study, published in JAMA, is further evidence of a “long tail” of Covid-19 related illness, say experts.

In the waning phase of the pandemic, beginning on April 21, 2020, the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy, established a post-acute outpatient service for individuals discharged from the hospital after recovery from Covid-19. All patients who met the World Health Organization (WHO) criteria for discontinuation of quarantine -- no fever for three consecutive days, improvement in other symptoms, and two negative test results for Covid-19 -- were followed up. At enrollment in the study, real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2 was performed and patients with a negative test result were included. 

Patients were asked to recount the presence or absence of symptoms during the acute phase of Covid-19 and whether each symptom persisted at the time of the visit. From April 21 to May 29, 2020, 179 patients were potentially eligible for the follow-up post-acute care assessment; 14 individuals (8%) refused to participate and 22 had a positive test result. Thus, 143 patients were included. The mean age was 56.5 years and 53 (37%) were women. The mean length of hospital stay was 13.5; 21 patients (15%) received noninvasive ventilation and seven patients (5%) received invasive ventilation. 

All patients who met the WHO criteria for discontinuation of quarantine, including no fever for 3 consecutive days, improvement in other symptoms, and 2 negative test results for Covid-19, were followed up. (Getty Images)

The researchers found that among patients who had recovered from Covid-19, 87.4% reported persistence of at least one symptom, particularly fatigue and dyspnea (shortness of breath). A detailed analysis shows that when patients were assessed a mean of 60.3 days after onset of the first Covid-19 symptom, only 18 (12.6%) were completely free of any Covid-19 related symptom, while 32% had one or two symptoms, and 55% had three or more. None of the patients had a fever or any signs or symptoms of acute illness. Worsened quality of life was reported by 44% of patients. A high proportion of patients still reported fatigue (53%), dyspnea (43%), joint pain (27%), and chest pain (22%).

A limitation of the study is that this is a single-center study with a relatively small number of patients and without a control group of patients discharged for other reasons. Patients with community-acquired pneumonia can also have persistent symptoms, suggesting that these findings may not be exclusive to Covid-19, says the team. However, based on their findings, the authors recommend that while clinicians and researchers have focused on the acute phase of Covid-19, “continued monitoring after discharge for long-lasting effects is needed.”

According to Cleveland Clinic, among the name unanswered questions regarding Covid-19, it is still unclear why some people are experiencing long-lasting symptoms and others are not. “We know that Covid-19 starts an inflammatory response in the body, which can cause a chain of events with many different symptoms. Unfortunately at this time, more research needs to be done to help us explain why this can lead to prolonged symptoms. In the future, we’ll be able to tell the long-term effects Covid-19 has on the kidneys, lungs, and heart, but we just aren’t there yet,” explains family medicine provider Dr Christopher Babiuch in an article.  

As health experts step in to try to manage these patients and learn more, many are referring to this group as coronavirus “long-haulers” or “long-termers.” “Long-lasting symptoms are fairly similar to what people experience in the acute phase of the illness, but typically not as severe. It often includes coughing, tightness in the chest, shortness of breath, and diarrhea. But perhaps the most significant symptom that is being seen across the board in coronavirus long-haulers is fatigue,” says Dr Babiuch. According to the expert, often this group feels very run down and tired. “They can’t exert themselves or exercise and simple tasks (like walking to the mailbox) will often leave them feeling exhausted. Chronic fatigue like we’re seeing in this group can be incredibly debilitating and frustrating,” writes Babiuch.

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